On call

Cynthia “Cigi” Smith (second from right) is GVFD's new Family Nurse Practitioner

A nurse practitioner is now working for Green Valley Fire District, helping with medical-aid calls in a program believed to be the first in the nation.

The recently launched Fire-Based Urgent Medical Services Program is a culmination of years of work that began in earnest after Acting Battalion Chief Dan Modrzejewski found in his master's degree studies that up to 25 percent of residents who called 911 didn't require emergency care. With no alternative, the patients often were taken by ambulance to Tucson hospitals, an unnecessary and costly expense.

Many Green Valley residents weren't willing, or in some cases able, to go to their primary care physician or urgent care due to financial, mobility or other issues, but did call 911. District officials discussed the matter in-depth and decided to craft its own program.

As a result, a Family Nurse Practitioner has been responding to emergency calls since early March, believed to be the first effort of its kind in the country, said Katie Sayre, GVFD Division Chief of Community Services and program administrator. It's part of a growing “community medicine” healthcare trend aiming to better address health-related issues and reduce costly ER visits as well as save on expenses for fire districts becoming increasingly strapped for tax-based funds.

A hospital trip and ER visit can run about $2,100 to the nearest Tucson hospital, St. Mary's, Sayre noted. Home treatment by an FNP runs about $300. The district has applied for and plans to accept coverage by Medicare, AHCCCS and most insurance plans to help patients pay charges for the on-site visit.

Modrzejewski's studies, conducted over four months, demonstrated that of 1,629 transports to the emergency department, 448 could have been treated at home by a nurse practitioner, translating to considerable unnecessary resources. The NP's role is to provide urgent medical care in situations such as moderate back pain, mild respiratory problems, dehydration, diarrhea, minor wound infections, simple fractures and sprains, mild skin burns, rashes, cuts requiring stitches, tests for strep, flu and other illnesses, to bridge the gap until a patient at home can see their own physician. The NP also will help manage a patient's medication and prescriptions.

GVFD was recently licensed by the state Health Department as an Unclassified Healthcare Institution to provide urgent care services on calls with first responder crews. The district's program differs from others in that it has its own FNP on staff and is licensed to provide them independent of a grant, privately funded hospital, clinic or urgent care facility. The FNP does not ride along with ambulance crews.

The district set aside $120,000 of the current year's $8.8 million budget to get the program up, running and staffed, including research and development, legalities and several months' pay for the practitioner. District administrators projected the program will bring in about $27,000 for the rest of the fiscal year, earmarked for the district operating fund.

Kitty Bottemiller | 547-9732

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